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I suspected my Cavalier has SM but now I'm almost positive. Please help

Shay said:
I am kinda in the same boat as you with the PSOM. The neuro will not do the PSOM surgery without doing another MRI at the cost of $1900.00, which to me is crazy. When she was first diagnosed with it, no treatment was offered, and it was kinda like it was not a big issue. Lily did much better with the gabapentin for several months, and yelping was never really one of her symptoms. She yelped only occasionally if you picked her up. When they yelp, it's because they are in pain, so certainly the PSOM could cause them to yelp.

If it were me, I would try the gabapentin first, and see if that helps, because gabapentin does not help with PSOM. If her symptoms improve with the gaba, then more than likely the SM is what is causing Chloe the pain. As far as the vertigo, it's so hard to say, but my neuro thinks that the PSOM caused that, but is not positive. She is much better with the vertigo now, and it did take almost 2 weeks for her to get over that spell, and get back to normal. So if that is what Chloe had, and it sounds so much like what Lily had, it does take a while for them to get over that. Lily is back to her playful self now. If you can, I would push for an MRI though, because that will tell you exactly what you are dealing with. Along with the MRI, they found Lily had a grade 2 luxating patella, which required no surgery, and she had injured a disk in her back at some point, probably from jumping or twisting. I try never to let her jump off a bed, or anything high. It's just good to know if they have a syrinx, and does give you some peace of mind knowing what you are dealing with, and lets you make decisions based on facts, and not just guessing. Even though Lily has a very small syrinx, she has moderate symptoms. Symptoms rarely follow the actual degree of the disease. The main goal here is to manage the pain, whether you choose surgery or not. The neuro told me Lily was borderline for surgery, and I opted to treat with meds to see how she did. I am just now asking for her meds to be increased after a year. As I long as I can manage her pain with meds, I will not consider surgery.

Every dog is different, and it's so hard to know what to do, but managing the pain is the first priority, so I think it was a great decision that you asked for the gabapentin. And as a said, I would get the MRI as soon as you can do it. Then you could rule out the PSOM if she doesn't have it, and you would know her pain was only from the SM or whatever else the MRI shows, and not PSOM. If she did have PSOM, then you could treat that as well. I am going to have to find someone who will do the PSOM procedure who does not require another $1900 MRI :sl*p:.
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Thanks again for your help, Shay. Since Chloe and Lily's symptoms were so similar, I'm hoping she does as well as Lily did. Chloe took her first Gabapentin tonight and now she's very tired, even more so than she has been before. Compared to yesterday she seems worse because her tail has been permanently stuck between her legs. Her appetite is still great but she seems not so good today, unfortunately.

Last night, when we took her out she wanted to run and run and run. Her tail would wag, etc. Today, nothing.

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Do you think the drowsy effect from the Gabapentin has something to do with why she's so tired today? I asked the neuro for a low dose and saw at the pharmacy that he prescribed 100mg, 3x a day. Is that normal for a low dose or should I do 50mg 3x a day?

Also, I saw her try to scratch just now and still she didn't seem to be able to do it. It was weak attempt to scratch, unlike her previous vigorous scratching.
 
I am so sorry Chloe is not feeling well. Yes, the gabapentin most definitely will make her drowsy, especially at first. I think Lily was really on an exceptionally low dose and as some have said here, almost to the point of not really enough to be affective, although I did see improvement in the beginning. I think three times per day is good, because Lily was only prescribed 2 per day, and gaba only works for 8 hours. I could tell by about 4:00 in the afternoon it had worn off, because she would start scratching. I think 100 mgs is a pretty standard first dosing, and I never understood why my neuro started Lily on such a low dose. When I asked about it, all he said was that he wanted her on the lowest dose possible, because she would be on it the rest of her life. I have still not heard from the neuro from last Friday, when he did a blood draw to see what Lily's gaba levels were so he can adjust her dose. I have a call in to him, and I am getting very frustrated. I am starting to feel like the visit last Friday was a waste of time and money, because nothing has really been done for her. Thank God she got over the vertigo on her own, for now at least.

I would go with the prescribed dose and see how Chloe does. You want it to be enough to manage her pain. She could be tired and hurting because she played so hard yesterday. Getting excited and vigorous play can make their symptoms worse. When Lily had the vestibular episodes, we had a vigorous ball throwing session the day before. Coincidence? Maybe, but it could have played a part. It is so hard to not let them be a dog when they want to play. Sometimes, they pay for it later.

It's good Chloe has an appetite, and Lily has never passed up a meal either. She loves to eat, and I am happy for that. Give it a few days, and if she is not any better, I would push for the MRI to make sure it is in fact SM, and there is not something else going on. I wish I could afford Lyrica, but right now it is not available in generic and probably won't be for a few years. It seems that owners who are using it are getting better results than with the gaba. But someone told me it was costing them like $2.00 a pill :shock:. With my rescue cav taking 2 meds a day for his MVD, there is just no way we can do that right now.

Please let me know how she is doing tomorrow. Fingers and paws crossed here she will better. :xfngr:
 
I am so sorry to hear that chloe is not feeling well. It sounds like Dr. West is great however I have a strong opinion about getting an mri. I agree with karlin that without an mri it is hard to determine amything. I really don't see how. I would like to share that ellas vet said that he would not recommend an mri and wait and see. I ended up getting an mri after making him give me a referral.

Ella turned out to be severe and even though it might not be the same, her progression was fast. Ella never yelped and others did not see what I did so saying symptoms to reflect severity is why I feel so strongly. Yes cost is an issue as I know. An mri is not mean surgery. It could give a prospective of what is going on.

I would also say ella will be one way and the next I thinking she seems fine. There could be other things than sm and an mri would confirm either way. Even it shows sm it doesn't mean the worse (surgery). I am so thankful I did not listen to her vet before more damage was done. Ella was sever so dn't think it is a reflection of chloe.

To sum up:
Symptoms seem to not reflect severity (ella did not yelp and still was playful)
Actually she still is sometimes.
Without mri and questioning the "wait and see" I stronly feel it was a saving factor.
Agree that dr. Dewey is well known and knows a great deal (actually my neurologist recently talked to him about an issue with ella)
I agree with blondiemaster that pushing surgery seemed concerning to me)

Finally the best point is you are in the right place. So many people offered support, a place where a lot of people care. I don't know what I would have done without these great friends I met. No matter what, people here will be there for you.

I know its scary and we hate to see our loved ones feel bad.

Please keep her posted.
 
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